Medicina pulmonar y respiratoria

Impact of Long-term Employment of a Self-Management Program in Asthmatics

Abstract

Gilles Devouassoux, Nathalie Freymond, Laurent Laforest, Thierry Vitry, Alexis Cazaux, Yves Pacheco

Background: Self-management of asthmatics is thought to facilitate early detection and treatment of asthma exacerbations, and to reduce asthma-related morbidity and mortality.
Aim: To evaluate the efficacy of a self-management program on the long-term follow-up of asthma and determine the factors influencing the success of such program in asthmatic patients.
Methods: Objective parameters (criteria of asthma control, FEV1 and FEV1/FVC) were assessed at inclusion and at the end of the retrospective study, 8.9±8 years later, using a 1-year recall patient-based questionnaire and lung function measurements.
Results: Among the 112 patients who answered the questionnaire (63% of response), 69 patients followed the self-management program, either partially with the help of a phone call to their physician (22%) or exclusively (78%), the latter displaying higher education levels (p<0.05). In the “self-management” group, GINA status was stabilized or improved (80%), FEV1 was significantly improved, a less frequent use of emergency services was reported, corticosteroid dependence was reduced (22% vs. 7%, p=0.03) and smoking dropped (p=0.05). Additionally, higher global quality of life scores were obtained in the self-management group (21% vs. 7.9%, p= 0.05).
Conclusion: A self-management program significantly improved control of asthma and quality of life of asthmatics. Because control of asthma is lacking for the vast majority of asthmatics, these results argue for an usual employment of such program in the long term follow-up of asthmatics.